Montana Cancer Consortium CCOP (MCC) has since 1996 provided access to NCI-sponsored clinical trials for the oncology community of Montana and Wyoming. MCC serves over 1 million people in a rural area covering nearly 200,000 square miles. Montana health care quality ranks among the highest in the country, but access to care ranks low due to the vastness of the region and concentration of the medical community in a few widespread cities. The CCOP membership includes 12 affiliate performance sites and 39 physician members. As the physicians work to access the population through outlying clinics hundreds of miles from home, MCC provides access to state-of-the-art cancer treatment, prevention, and control via cutting-edge research of NCI-sponsored trials. This uniquely rural population includes seven Montana Native American reservations that do not have convenient access to large university-based treatment facilities. Without nationally-recognized clinical trial, patients would not have access to a high level of cancer care. MCC intends to extend access by expanding the physician roster to include other disciplines such as surgery and pediatric oncology. MCC is currently affiliated with four adult research bases, SWOG, NSABP, NCCTG, and RTOG as well as CTSU. MCC is actively pursuing affiliation with COG with the addition of pediatric oncology services in two of the affiliate sites. COG membership will expand the CCOP membership and patient base and increase the number of patients accrued annually. MCC accrual has declined over the last grant cycle; however revised membership requirements and renewed interest of participating members is expected to positively impact accrual in the future. MCC is dedicated to maintaining a quality program. Centralized research coordination and an internal quality assurance program ensures quality data, patient safety, and clinical trial compliance. Human subject protection is achieved through local centralized IRB review and annual membership requirements. Drug accountability is met through use of a centralized pharmacy and supervised satellites. The MCC goal is to maintain and enhance this level of quality through education and increased communication and to increase accrual over the next grant cycle.